CPT code 39402: Mediastinoscopy, lymph node biopsy2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 39402 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 39402 covers

A thoracic surgeon advances a mediastinoscope through an incision at the base of the neck to reach mediastinal lymph nodes and obtain tissue for pathology. A common use is sampling nodes to stage lung cancer; mediastinal lymphadenopathy or suspected lymphoma may also prompt tissue diagnosis. The service is typically performed in a hospital operating room under anesthesia.

Report the code when lymph node tissue is sampled through the mediastinoscopic approach; the biopsy is part of the service, rather than a separate biopsy charge for those nodes. The operative report should identify the approach and sampled nodal sites. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 39402 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 39402 rate is calculated

Each of 39402’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 39402

The CMS indicators that decide how 39402 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

39402 compared with similar codes

How to choose

39401MediastinoscopyMediastinal tissue biopsy

Choose 39402 for mediastinoscopic sampling of lymph nodes. Code 39401 is associated with mediastinal biopsy that is not described as lymph node biopsy.

39499Mediastinal procedureUnlisted procedure

Use 39402 when the service is mediastinoscopic lymph node biopsy. The unlisted code is for a mediastinal procedure that lacks a specific listed code.

32606Thoracoscopy biopsyMediastinal mass

Code 32606 describes diagnostic thoracoscopy with mediastinal tissue biopsy; 39402 describes lymph node sampling by mediastinoscopy.

Codes related to 39402

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates